Medicare Advantage Risk Adjustment Data Validation …
Jan 29, 2019 · • The Part C CMS-HCC model is used to pay MAO plans for non-End Stage Renal Disease (ESRD) enrollees (with 12 months of Medicare Part B coverage during the data reporting period [i.e., full risk beneficiaries]). • There are three (3) possible scores produced by the model: – Community: Based on enrollees with less than 90 days in an ...
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